Ramanan Laxminarayan – The Health Care Blog

Reduce Antibiotic Resistance: Get Your Flu Vaccine

Aug 11, 2011• 4

By LAURI HICKS, DO, SEEMA JAIN, MD, & RAMANAN LAXMINARAYAN

A study published in the July issue of Infection Control and Hospital Epidemiology shows that antibiotic prescriptions tend to spike during flu season, even though influenza is caused by a virus and cannot be treated with antibiotics.

Some of these antibiotic prescriptions are justified – bacterial pneumonia, which must be treated with antibiotics, is also common during the winter months. And getting the flu puts you at higher risk for developing complications from secondary infections, including bacterial pneumonia.

Yet some people suffering from the flu virus alone may demand–and get–an antibiotic even though viral infections do not respond to antibiotic treatment.

According to Extending the Cure, a nonprofit project funded by the Robert Wood Johnson Foundation’s Pioneer Portfolio, between 500,000 to one million antibiotic prescriptions are filled each year during flu season for patients who have the flu and no bacterial illness.

Why should we care about how many antibiotics are prescribed?

When antibiotics are overused or inappropriately used, bacteria can develop antibiotic resistance, or the ability to withstand antibiotic treatment, making bacterial infections difficult to treat. Antibiotic resistance can develop quickly. Today’s antibiotics – the wonder drugs that transformed modern medicine – are used so commonly that we face the prospect of a future with a multitude of resistant bacteria and a shelf full of ineffective drugs.

Visualizing the Threat Posed by Antibiotic Resistance

Mar 4, 2011• 18

By JOHN LUMPKIN and RAMANAN LAXMINARAYAN

For the first time, researchers and policymakers can visually track the rise in “superbug” infections over time and identify regions of the country with rapidly spreading rates of resistance.

Researchers at Extending the Cure, a nonprofit project funded by the Robert Wood Johnson Foundation’s Pioneer Portfolio, have developed ResistanceMap—an online tool that tracks changes in resistance levels. These maps show us how the problem of antibiotic resistance has gotten worse–with some regions of the country experiencing a significant and worrying increase in drug- resistant microbes.

Infections like those caused by MRSA (methicillin-resistant Staphylococcus aureus) kill an estimated 100,000 people in the United States each year. Progress toward solving this emerging public health crisis has been slow, an important reason why the Robert Wood Johnson Foundation has funded this research through its Pioneer Portfolio. We share a common view that the best way to prevent an epidemic from occurring may lie in dramatically reframing how we approach the problem.

This is exactly what Extending the Cure has done with ResistanceMap, a web tool that presents scientific data in a user-friendly way, allowing policymakers and researchers to quickly identify regions in urgent need of better infection control, enhanced surveillance, more vigilant antibiotic stewardship, and comprehensive methods to curtail the spread of resistant microbes.Continue reading…

NDM-1: Why Should the U.S. Care?

Oct 14, 2010• 3

By RAMANAN LAXMINARAYAN and HELLEN GELBAND

Why should the United States care about health problems in distant, poor countries when there are pressing priorities here at home? It’s a classic question. People trying to influence policy have never trusted humanitarianism to carry the day and have instead appealed to the self-interest of U.S. citizens. When it comes to health, U.S. travelers heading to foreign lands for tourism or work need protection from disease or at least the promise of a cure when they return home. Of utmost concern, the military sends large numbers of troops where they are in danger not only from armed conflict, but also from exotic (and often dangerous) diseases.

But no tropical disease can make as clear a case for U.S. self-interest as antibiotic resistance can: witness the furor over NDM-1—the resistance gene that seems to have arisen in patients on the Indian subcontinent. Was the furor over a health problem in India and Pakistan? No. The news that hit U.S. and European newspapers was over the report about NDM-1 in Lancet Infectious Diseases that identified people in England who had had surgery in India—“medical tourists”—as victims, and warned that the UK National Health Service might suffer financially because patients coming home had to be hospitalized and treated with expensive antibiotics to cure their infections. These just as easily could have been Americans—and now they are: NDM-1 was found in three U.S. medical tourists (and one Japanese man) on their return from India.